Rehab

CMS releases therapy cap exceptions policy

Rehab Regs, February 17, 2006

CMS announced its plans for an exceptions process to the therapy cap which allow some beneficiaries automatic exceptions, earlier this week in three transmittals.

The American Physical Therapy Association (APTA) lauded the move, though Ben F. Massey Jr., PT, MA, president of APTA, also stressed the desire for a complete repeal of the cap in the future.

"CMS has made a good effort to ensure that Medicare beneficiaries who need the most care are not harmed by an arbitrary cap," Massey said in a release. "We have yet to see how well Medicare contractors will be able to implement and apply this process. Congress must address this issue again this year, and we are confident that this experience will demonstrate to legislators that they must completely repeal the caps."

The exceptions process allows for beneficiaries with specified conditions to receive automatic exceptions and others to earn up to 15 additional visits through a written appeal by the provider.

To view Transmittal 46, click here. For Transmittal 139, click here and for Transmittal 853, click here.

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